Source: Cancer Resource Room
Neuroblastoma is a disease in which malignant
(cancer) cells form in nerve tissue of
the adrenal gland, neck, chest, or spinal
Neuroblastoma often begins in the nerve
tissue of the adrenal glands. There are
two adrenal glands, one on top of each
kidney in the back of the upper abdomen.
The adrenal glands produce important hormones
that help control heart rate, blood pressure,
blood sugar, and the way the body reacts
to stress. Neuroblastoma may also begin
in the chest, in nerve tissue near the
spine in the neck, or in the spinal cord.
Neuroblastoma most often begins during
early childhood, usually in children younger
than 5 years. It sometimes forms before
birth but is usually found later, when
the tumor begins to grow and cause symptoms.
In rare cases, neuroblastoma may be found
before birth by fetal ultrasound.
By the time neuroblastoma is diagnosed,
the cancer has usually metastasized (spread),
most often to the lymph nodes, bones,
bone marrow, liver, and skin.
Possible signs of neuroblastoma
include bone pain and a lump in the abdomen,
neck, or chest.
The most common symptoms of neuroblastoma
are caused by the tumor pressing on nearby
tissues as it grows or by cancer spreading
to the bone. These and other symptoms
may be caused by neuroblastoma or by other
conditions. A doctor should be consulted
if any of the following problems occur:
- Lump in the abdomen, neck, or chest.
- Bulging eyes.
- Dark circles around the eyes ("black
- Bone pain.
- Swollen stomach and breathing problems
- Painless, bluish lumps under the skin
- Weakness or paralysis (loss of ability
to move a body part).
Less common signs of neuroblastoma include
- Shortness of breath
- Feeling tired
- Easy bruising or bleeding
- Petechiae (flat, pinpoint spots under
the skin caused by bleeding)
- High blood pressure
- Severe watery diarrhea
- Jerky muscle movements
- Uncontrolled eye movement
- Swelling of the legs, ankles, feet,
examine many different body tissues and
fluids are used to detect (find) and diagnose
The following tests and procedures may
- Physical exam and history: An exam
of the body to check general signs
of health, including checking for
signs of disease, such as lumps or
anything else that seems unusual.
A history of the patient’s health
habits and past illnesses and treatments
will also be taken.
- Twenty-four-hour urine test: A test
in which a urine sample is checked
to measure the amounts of certain
substances. An unusual (higher- or
lower-than-normal) amount of a substance
can be a sign of disease in the organ
or tissue that produces it. A higher-than-normal
amount of the substances homovanillic
acid (HMA) and vanillyl mandelic acid
(VMA) may be a sign of neuroblastoma.
- Blood chemistry study: A procedure
in which a blood sample is checked
to measure the amounts of certain
substances released into the blood
by organs and tissues in the body.
An unusual (higher- or lower-than-normal)
amount of a substance can be a sign
of disease in the organ or tissue
that produces it. A higher-than-normal
amount of the hormones dopamine and
norepinephrine may be a sign of neuroblastoma.
- Cytogenetic analysis: A test in which
cells in a sample of tumor tissue
are viewed under a microscope to look
for certain changes in the chromosomes.
- Bone marrow aspiration and biopsy:
The removal of a small piece of bone
and bone marrow by inserting a needle
into the hipbone or breastbone. A
pathologist views both the bone and
the bone marrow samples under a microscope
to look for abnormal cells.
- Biopsy: The removal of cells or tissues
so they can be viewed under a microscope
to check for signs of cancer.
- X-ray: An x-ray is a type of energy
beam that can go through the body
and onto film, making a picture of
areas inside the body.
- CT scan (CAT scan): A procedure that
makes a series of detailed pictures
of areas inside the body, taken from
different angles. The pictures are
made by a computer linked to an x-ray
machine. A dye may be injected into
a vein or swallowed to help the organs
or tissues show up more clearly. This
procedure is also called computed
tomography, computerized tomography,
or computerized axial tomography.
- Neurological exam: A series of questions
and tests to check the brain, spinal
cord, and nerve function. The exam
checks a person’s mental status,
coordination, ability to walk normally,
and how well the muscles, senses,
and reflexes work. This may also be
called a neuro exam or a neurologic
- Ultrasound: A procedure in which high-energy
sound waves (ultrasound) are bounced
off internal tissues or organs and
make echoes. The echoes form a picture
of body tissues called a sonogram.
- Immunohistochemistry study: A procedure
in which dyes or enzymes are added
to a blood or bone marrow sample to
test for certain antigens (proteins
that stimulate the body's immune response).
Certain factors affect prognosis
(chance of recovery) and treatment options.
The prognosis (chance of recovery)
and treatment options depend on the following:
- Age of the child when diagnosed.
- Stage of the cancer.
- Where the tumor is in the body.
- Tumor histology (the shape, function,
and structure of the tumor cells).
Prognosis is also affected by tumor biology.
In neuroblastoma, tumor biology is described
according to the following:
- The patterns of the tumor cells.
- How different the tumor cells are
from normal cells.
- How fast the tumor cells are growing.
- The number of chromosomes in the tumor
- How many copies of the N-myc gene
The tumor biology is said to be favorable
or unfavorable, depending on these factors.
A favorable tumor biology means there
is a better chance of recovery. To read
more about Neuroblastoma
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